Active NPI
Glyn E Marsh, MD
- Otolaryngology Physician
- Walla Walla, WA
National Provider Identifier
1336163005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- MD00022960
- Practice address
- 301 W Poplar St
Suite 210
Walla Walla, WA 99362 - Phone
- (509) 522-5825
- Fax
- (509) 529-3512
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | MD00022960 | WA | Primary |
Addresses
Primary practice location
301 W Poplar St
Suite 210
Walla Walla, WA 99362
Mailing address
PO Box 34439
Seattle, WA 98124-1439
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336163005 | Medicaid | WA | |
| 127886 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334793600000",
"number": "1336163005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34439",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981241439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 W POPLAR ST",
"address_2": "SUITE 210",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "99362",
"telephone_number": "509-522-5825",
"fax_number": "509-529-3512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSH",
"first_name": "GLYN",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2012-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "WA",
"license": "MD00022960",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1336163005",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "127886",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.